On her TV shows “Work Out” and “Thintervention,” celebrity trainer Jackie Warner pushes clients to reach their fitness and weight-loss goals. Now, she’s teaming with a top dermatologist to help psoriasis sufferers conquer obesity and heart disease, problems often related to the painful skin condition. In this exclusive Lifescript interview, Warner and Paul Yamauchi, M.D., discuss how people with psoriasis symptoms can improve their fitness and overall health...

When you have psoriasis, symptoms like itching, burning and dry, cracked skin can make it painful to work out.

Fitness expert Jackie Warner understands this. Her grandmother suffered from the uncomfortable skin condition for many years.

People with psoriasis are at greater risk for obesity and depression, he says.

“They also have a higher propensity for heart attacks and stroke,” Yamauchi adds.

Together, he and Warner have come up with a solution: an exercise and wellness program for people with psoriasis symptoms called Fit in Your Skin.

In this Lifescript exclusive, Warner and Yamauchi share the latest psoriasis treatments, and discuss how people with the condition can lead a healthier lifestyle in spite of pain and discomfort.

On her TV shows “Work Out” and “Thintervention,” celebrity trainer Jackie Warner pushes clients to reach their fitness and weight-loss goals. Now, she’s teaming with a top dermatologist to help psoriasis sufferers conquer obesity and heart disease, problems often related to the painful skin condition. In this exclusive Lifescript interview, Warner and Paul Yamauchi, M.D., discuss how people with psoriasis symptoms can improve their fitness and overall health...

What’s the biggest misconception about psoriasis?Yamauchi: The myth that it’s simply a cosmetic [problem].

It’s a systemic [full-body] disease – it’s linked to cardiovascular disease and associated with psoriatic arthritis. It takes time away from family and work, and really alters the quality of one’s life.

Is there a lifestyle component to battling psoriasis symptoms? Warner: Yes. [Besides medical interventions], you have to tackle psoriasis from three angles: emotional, fitness and nutritional aspects.

Yamauchi: Studies show psoriasis patients die a few years earlier than the general population, due to other [health-related] factors.

For example, a lot of psoriasis patients are overweight, have hypertension, type 2 diabetes, increased triglycerides and not enough HDL (the “good” cholesterol). As a result, they end up with a higher propensity for heart attacks and stroke.

That’s why we’re teaching patients who have psoriasis to exercise, stay fit and eat a well-balanced diet that’s good for the heart.

How does an exercise program for people with psoriasis symptoms differ from other workouts? Warner: If you have plaques on your joints, it’s very difficult to have a full range of motion when you perform certain exercise movements. [Plaques are silvery-white skin scales that often form on the knees and elbows, as well as the torso, nails, scalp and sometimes the face.]

On the DVD, I made modifications such as limiting multi-joint movements and keeping people upright and on their feet. For example, to work the chest muscles, we stand up and do dumbbell exercises instead of doing push-ups on the floor.

What kind of nutritional advice do you offer? Warner: To ward off heart disease and fight obesity, people who have psoriasis should be eating nuts, seeds, fruits and low-fat [dairy products]. Whole grains and oatmeal are fantastic too.

Stay away from fried foods, saturated fats and high sugar content.

On her TV shows “Work Out” and “Thintervention,” celebrity trainer Jackie Warner pushes clients to reach their fitness and weight-loss goals. Now, she’s teaming with a top dermatologist to help psoriasis sufferers conquer obesity and heart disease, problems often related to the painful skin condition. In this exclusive Lifescript interview, Warner and Paul Yamauchi, M.D., discuss how people with psoriasis symptoms can improve their fitness and overall health...

Jackie, what's your personal connection to psoriasis?Warner: My grandmother developed psoriasis later in life. It came out of nowhere. She started getting the plaques in her elbow joints and all over her hands.

What other changes did you see in her? Warner: She went from a 120-pound, fit woman to a 200-pound, obese woman. It literally happened in about a year’s time, which is a huge stress on the body.

She also started to suffer from depression. She didn’t like going out… she covered up more.Did she ever get a handle on her condition?Warner: She actually did slim down. A doctor gave her a walking workout program she could manage. I used to go walking around the neighborhood with her.

She also tackled the weight issues head-on by decreasing saturated fats and sugar intake.

There’s a genetic component to autoimmune disease. Do you worry about your own health?Warner: It’s an interesting question, because my mother – who hasn’t followed a fitness lifestyle or a nutrition-conscious eating plan throughout her life – has had many [health problems]. She had lymphoma, serious foot and knee disorders and a full hysterectomy, all by age 35.

I’m 42 and very healthy, and I credit my fitness lifestyle. I care about what I eat, and that makes all the difference in the world.

Dr. Yamauchi, you mentioned a link between psoriasis and heart disease. Which problem leads to the other?Yamauchi: It’s hard to tell what comes first.

The average psoriasis patient [weighs] 200 pounds. There are studies showing that obesity is a risk factor for psoriasis, but other studies show the opposite – that psoriasis is a risk factor for obesity.

On her TV shows “Work Out” and “Thintervention,” celebrity trainer Jackie Warner pushes clients to reach their fitness and weight-loss goals. Now, she’s teaming with a top dermatologist to help psoriasis sufferers conquer obesity and heart disease, problems often related to the painful skin condition. In this exclusive Lifescript interview, Warner and Paul Yamauchi, M.D., discuss how people with psoriasis symptoms can improve their fitness and overall health...

People who have psoriasis symptoms are at risk for depression, and they often live a sedentary, less social lifestyle. They eat more, drink more and don’t burn it off, all of which raises the risk for heart disease.

Do you usually discuss diet and fitness with your psoriasis patients? Yamauchi: Yes. If I feel a patient has a metabolic syndrome associated with being overweight, I tell them about the link to cardiovascular disease and advise them to lose weight, work out, eat a heart-healthy diet, and reduce stress in their lives.

If the patient doesn’t have a regular primary-care doctor, I refer them to a physician to check for diabetes, [high] cholesterol and issues like that.

What are the latest medical options for psoriasis symptoms? Yamauchi: We have more ways to treat psoriasis now than ever before.

If a case is mild, we handle it with topical creams containing cortisone or vitamin D.

What about the more advanced cases?Yamauchi: We use ultraviolet-light therapy. It’s similar to going to a tanning salon except the patient is under close medical supervision.

How often do patients need those treatments? Is it long-term?Yamauchi: It’s 2-3 times a week for several weeks up to a few months, until the psoriasis is clear or in remission. Remissions can last several weeks or a few months.

If a person has a busy schedule because of work or school, they can’t do ultraviolet therapy. It’s a tough schedule to maintain.

On her TV shows “Work Out” and “Thintervention,” celebrity trainer Jackie Warner pushes clients to reach their fitness and weight-loss goals. Now, she’s teaming with a top dermatologist to help psoriasis sufferers conquer obesity and heart disease, problems often related to the painful skin condition. In this exclusive Lifescript interview, Warner and Paul Yamauchi, M.D., discuss how people with psoriasis symptoms can improve their fitness and overall health...

Does it put patients at risk for other skin problems? Yamauchi: If a person overdoes the ultraviolet therapy – and I’m talking about hundreds of sessions – then there’s a risk of developing skin cancer and premature aging of the skin.

Can getting out in the sun also be helpful in clearing a flare-up?Yamauchi: If a patient can’t do anything else to treat psoriasis because they have no money, insurance or time for ultraviolet-light therapy, then going outside and getting some sunshine can help.

What are the latest psoriasis treatments for advanced cases? Yamauchi: The new trend in treating psoriasis, as well as other autoimmune disorders, is shots with biological agents [drugs created by a biological process instead of chemical synthesis]. The patient self-injects at home or goes to the physician’s office to have the shot administered.

Are the shots also long term? Yamauchi: Yes. They’re not a cure – these shots just treat psoriasis symptoms until they disappear and the patient can enjoy a better quality of life.

They’re given every three months.

Are the injections helpful in controlling other health problems associated with psoriasis? Yamauchi: They’re proving not only beneficial as a way to treat psoriasis, but also for other inflammations. One recent report indicated that the injections can reduce the incidence of cardiovascular disease by 50%.

Some of the shots are being used to treat psoriatic arthritis too. About 30%of people who have psoriasis develop arthritis in their hands and feet, and they often have stiffness in their backs and spines too.

The psoriasis appears first and then, 10 years later, the arthritis develops. It can be quite crippling.

On her TV shows “Work Out” and “Thintervention,” celebrity trainer Jackie Warner pushes clients to reach their fitness and weight-loss goals. Now, she’s teaming with a top dermatologist to help psoriasis sufferers conquer obesity and heart disease, problems often related to the painful skin condition. In this exclusive Lifescript interview, Warner and Paul Yamauchi, M.D., discuss how people with psoriasis symptoms can improve their fitness and overall health...

It sounds like this is a major development.Yamauchi: Yes. Currently there are about five [of these drugs] on the market to treat psoriasis.

Psoriasis is an autoimmune disease, and these shots target a specific pathway [to calm] the body’s immune system.

They help to improve psoriasis symptoms so patients can enjoy life more. They go out in public more, go swimming, [and don’t mind] exposing their skin.

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